ONE Hostel program based in Gainesville with some operations in Jacksonville, Orange Park and Palatka has agreed to pay about $5.1 million to resolve allegations that it knowingly billed the government for unnecessary services by making false claims to Medicare and Medicaid for unnecessary medical care, according to the U.S. Attorney's Office.
Since mid-2011, Haven has treated at least 63 patients with a length of stay of more than three years, according to the US Attorney's Office. Normally, federal health care programs pay for hospice care only when patients are terminally ill and have a life expectancy of less than six months.
Federal investigators say Haven either knowingly or recklessly failed to document a valid basis for initial hospice care or subsequent coverage for these patients. It states that the hospice's medical diagnoses were not adequately supported or had inconsistent medical information. Many of the patients showed no objective signs of deterioration during their stay at Haven Hospice, prosecutors said.
“If left unchecked, this misconduct would deplete funds available for terminally ill patients who desperately need the relief that hospice care provides,” said Assistant U.S. Attorney Muldrow.
In a statement issued Thursday, Haven Hospice President Gayle Mattson said it agreed to resolve disputed claims “without any admission of liability in order to avoid the delay and cost of litigation,” adding that hospice care is a “complex and ongoing changing industry' where It is common for there to be different interpretations of regulations.
The settlement concludes a lawsuit originally filed in U.S. District Court by a former Haven Hospice doctor, John Simons, under provisions of the False Claims Act whistleblowers. The Jacksonville doctor will receive about $900,000 in proceeds from the settlement with Haven, the U.S. Attorney's Office said.
